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HYDRO30953
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Last modified
8/24/2016 8:54:43 PM
Creation date
11/21/2007 1:04:25 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981008
IBM Index Class Name
Hydrology
Doc Date
8/3/2001
Doc Name
2nd Q 2001 DMRs/ cant read
Permit Index Doc Type
DMR’s
Media Type
D
Archive
No
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r <br />PERMITTEE NAME/A~7DRESS pedude Fanfiy xenr./Laanen jD f/e,r,rq <br />NAME <br />ADDRESS - - ' <br />FAauTV '- <br />LOCATION <br />NATIONAL POLLUTAM DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHAAGE MONITORING REPORT (DMA) <br />. _., - , <br />PERMIT NUMBER DISCHARGE NUMBER _ <br />MONITORING PERIOD ~ - ' <br />YEAR MO DAY YEAR MO DAY <br />Form Approved. <br />OMB No. 2040.0004 <br />FROM TO <br />NOTE: Read Instructions before'Completing this form. <br /> QUANTITY OR LOADING QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />PARAMETER EX OF TYPE <br /> AVERAGE MAXIMUM UNRS MINIMUM AVERAGE MAXIMUM UNITS ava'~ts <br /> <br />~ <br />? <br />! <br />7 ( ~ <br />~ I <br />ir' <br />l~ l <br />~1~~; <br /> MEASUREMENT , <br />i C ( <br />.. .. .. PERMIT - - ~ .- . .- ~ - . - <br />- ~ REQUIREMENT <br />!. i : - ... <br />~ SAMPLE <br />MEASUREMENT ~ ~ <br />e: i~ <br />~ <br />S <br />~ ~.. ~ (~ <br />'1,:~ . C) <br />r' _ <br />I ' <br />`. /~ <br />", <br />e <br />_ ," _ _ . <br />C , JU . <br />. <br />~.. :f1 .. ,. i PERMIT .. .. •t-: +.., r,-;~ - - <br />_ _ 5 •~ ~• REQUIREMENT <br />- ~~ ~ ~ ~ SAMPLE <br />E <br />U <br />•[J <br />Lr•:~• <br />I <br />/ <br />Of <br />~ <br />l n <br />O <br />Lti. ~r.;q~~/ <br />- ~ <br />:~~ <br />I~~it <br />•'f`3 <br /> AS <br />REMENT <br />M . <br />• <br />c s <br />} <br />. / <br />t~„~: ii PERMIT ~ ~ ~ .; - ~ . . <br />,; ~~ ~ <br />.~ REQUIREMENT <br />' - ~ ~~ SAMPLE <br />MEASUREMENT r~.~~.: ~.._ .~ <br />~ <br />'~ <br />~ ~ ~!C / <br />U <br />~p <br />I <br />/9 I , <br />l <br />%L'~Z <br /> . , . . I ~ j <br />%- ~ ~~ - PERMff - .... _ <br />"^r C ~ ~ _ ~ REQUIREMENT <br />. _ .. _ SAMPLE <br />U .. ~ <br />~~` r _ ` <br />~Ci i <br />~~ <br /> REMENT <br />MEAS ( <br />;5.. i PERMIT ... .. .. .. , <br />I ~ ~ ~ ~~ ~ ~~ ~ - REQUIREMENT ~ ~ ~ ~ ~ <br />!•.% , :7' r ~- .. <br />_ „ _ -_ _ ~ SAMPLE <br />MEASUREMENT <br />(:~, ~,~(J <br />~ ; _ ~ ~ i l <br />~ ~ ~ ~ ~ ~ - <br />(' <br />~"~ <br />. , r,. ".. J ~ PERMIT ~ - .. .. ,. <br />_ _ •~ ~ _ REQUIREMENT <br />_ .-~ .. SAMPLE <br />MEASUREMENT ~ ~ :° <br />r ~ / ~ ti I'•ILi ~~, <br />~j~ <br />I '~., <br />~~' '• .l <br />i ..._ J PERMIT - - - - ~ ~ .. - <br />~~ ~ - ~ REQUIREMENT ~~ <br />NAMElTITLE PRINCIPAL EXECUTNE OFFICER I CarNy under penally of law Nat this tlowmant end ell attachments were <br />r <br />I <br />ar <br />tl <br />d <br />tl <br />ti <br />M <br />i <br />Mh <br />t <br />d <br />d <br />i <br />tl ~ / TELEPHONE DATE <br />'" <br />° p <br />ep <br />e <br />un <br />er my <br />rzec <br />on or supe <br />S <br />on <br />n ecror <br />ance x <br />a sys <br />em <br />as <br />gna ~ - <br />-, <br />,~ <br />rT <br />v I '% 1 ~-~1- • f .^- '`. <br />~ to a°.ure that quallMd personnb propaM1y gather mtl ovatuate Me vtlormaticn <br />submmetl <br />Based m n <br />In <br />ui <br />of the <br />erm or <br />ersons who mana <br />e Me s <br />tem y <br />/- - ~ <br />~ ~ ~ <br />~yl • ! "~ r" <br />. <br />' ry <br />. <br />q <br />p <br />N <br />g <br />ys <br />, <br />p _ <br />~~ <br />" I 6~ <br />, or those pemoro tliractly responslbla br gathering Melnlonnatbn <br />Me infamatlon -' r ~. j i~ • i <br />~ <br />i r <br />- <br />~ <br />, <br />~ , <br />eubmMetl Is <br />to Ma best army knowled <br />e and bellel <br />we <br />accurate <br />end com <br />lete ~ <br />, <br />J <br />, ~, <br />[,! l. <br />' ~ , <br />g <br />, <br />, <br />p <br />. <br />. <br />I <br />th <br />i <br />M <br />K <br />l <br />i <br />f <br />l <br />i SIGNATURE OF PRINCIPAL E%ECUTIVE <br /> <br />TYPED OR PRINTED am exam <br />ere ere s <br />gn <br />at <br />rartt pena <br />es <br />or submm,ng fa <br />se iMOrmat <br />t <br />on, <br />inclutli the ibll' of fine entl Im r,sonment br knowin Notations. OFFICER OR AUTHORfLED AGENT <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Relerence all attachments here) <br />EPA Form 3320.1 (REV 3/99) Previous editlons may be usetl. ` ~ - ' ~ ~ - .' ~ _ - . <br />'THIS IS A 4-PARY FORM PACE ~ ' f1F <br />
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